Errors in clinical judgment : the effect of temporal order of client information on anchoring, adjustment, and adjustment mitigation and category of clinical inferences

The anchoring effect influences clinicians to give undue diagnostic importance to client data gathered during the initial appraisal period. Moreover, client data consistent with the earlier diagnostic hypotheses may be given disproportionate credence.Extending research on the anchoring effect, 40 counsellors were presented with a written casefile in which the order of specific client information (that is, client material characterized as healthy and ailing) was systematically sequenced. A questionnaire was administered to evaluate the impact that the order of presentation of client information had on participant ratings of client functioning, and a "think-aloud" methodology was employed to examine the actual clinical inferences that participants generated as they read through the case material. These approaches unveiled divergent results. Questionnaire data revealed an anchoring effect associated with the presentation of healthy client material. "Think-aloud" data revealed an anchoring effect associated with the presentation of pathognomonic client material.A number of strategies are proposed to call clinicians' attention to the processes by which they encode details about their clients, and then generate and test hypotheses pertaining to them